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14 Cards in this Set
- Front
- Back
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How should mild hypoglycemia be treated? |
BG < 70 and no severe symptoms then 15-20 gm of glucose |
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How should severe hypoglycemia be treated? |
altered mental status, needs assistance from others glucagon 1 mg IM IV dextrose |
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What are common causes of diabetic ketoacidosis? |
2 most common -nonadherence or inadequate insulin therapy -infection others: -myocardial infarction -pancreatitis -stroke -drugs such as corticosteroids |
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What are common signs of DKA? |
polyuria, polydipsia, comitind, dehydration, weakness, AMS, coma, Kussmaul respirations, tachycardia, hyponatremia, hyperkalemia |
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What are Kussmaul respirations? |
deep and labored breathing pattern often associated with severe metabolic acidosis, particularly diabetic ketoacidosis (DKA) but also kidney failure. |
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How should DKA be treated? |
1. fluid replacement 2. Insulin drip -0.1 unit/kg/hour -increase if BG doesn't decrease 50-75 in first hour -will eventually need to reduce rate to keep BG between 150-200 3. replace potassium if needed 4. IV sodium bicarb if pH less than 6.9 |
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When is DKA considered resolved? |
When BG is less than 200 mg/dL and 2/3 of the following are present: i. venous pH greater than 7.3 ii. serum bicarb 15 mEq/L or greater iii. calculated anion gap of 12 mEq/L or less |
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What is a normal albumin/creatinine ratio? |
less than 30 mg/g |
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When is albuminuria diagnosed? |
if 2/3 albumin/creatinine ratio are 30 mg or greater over a 3-6 mo period |
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What drug should be added to reduce risk of nephropathy? When should it be initiated? |
ACEI or ARB if albumin/creatinine ration is 30 mg/g or greater |
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When should retinopathy monitoring begin? |
once dx of DM2 is made and screening should be done annually at first no pharmacotherapy; however, good glucose control helps prevent |
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What drugs can be used to treat diabetic neuropathy? |
Tricyclics -amitriptyline, desipramine -effective, but use limited due to anticholinergic effect Anticonvulsants -gabapentin, lamotrigine, pregabalin -pregabalin is only anticonvulsant w/ FDA approval for treating diabetic neuropathy SSRIs/SNRIs -duloxetine is only approved drug in this category Tramadol/APAP Opioids -tapetadol extended release is only approved drug in this category |
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What drugs can be used to treat gastroparesis? |
metoclopramide erythromycin |
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Reducing cardiovascular risk |
BP management w/ ACE or ARB Lipid management w/ a statin Low dose asa or clopidogrel |
